Pulse Methylprednisolone Therapy in Idiopathic, Rapidly Progressive Glomerulonephritis

Abstract

Idiopathic crescentic glomerulonephritis is associated with a 70-80% incidence of end-stage renal failure. Oral corticosteroid therapy in combination with immunosuppressive agents or anticoagulants has not altered the prognosis of this disease. Five adults with idiopathic crescentic glomerulonephritis and treated with i.v. methylprednisolone were studied. Before therapy, the average serum creatinine concentration was 7.4 .+-. 1.3 mg/dl (chi-square .+-. SEM [standard error of the mean]). This value declined to 2.0 .+-. 0.48 mg/dl within 4 wk. All patients continued to maintain stable renal function over an average follow-up period of 19 mo. (range, 1.5-36 mo.). A prospective controlled trial of this therapy is warranted in the management of this entity.